Unknown Individual – Obstetrics & Gynecology Physician, NPI 1336236207

Unknown Individual is a healthcare provider. based in Conroe, Texas. specializing in Obstetrics & Gynecology Physician. They hold a License No. D7766 (TX). The NPI Number for Unknown Individual is 1336236207

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336236207
Phone
(936) 760-4600
Address
508 MEDICAL CENTER BLVD
Deactivation Date
23 January 2025

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
8367604600
Graduation Year
1965 (61 years ago)
PAC ID
4385775352
Group Practice PAC ID
1850547365
Professional Enrollment ID
I20100708000693

Contacts

Secure Messaging
ALEXANDER.KLEIN@hca9.eclinicaldirectplus.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 508, Medical Center Boulevard, Conroe, Montgomery County, Texas, 77304, United States

    STE 200

    CONROE, TX 773042953

    Phone: (936) 760-4600

    Fax: (936) 760-4601

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-05-26 • Largest payer in this snapshot: Abbott Laboratories ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-26

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$14
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77304)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850547365View full group profile
NameSpecialtyState
Certified Nurse Midwife (Cnm)TX
General SurgeryTX
-TX
O B S T E T R I C S/ G Y N E C O L O G YTX
-TX
O T O L A R Y N G O L O G YTX
General Surgery, Critical Care (Intensivists)ID
General Surgery, Vascular SurgeryTX
General SurgeryTX
-TX

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1336236207 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Obstetrics & Gynecology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Conroe, Texas; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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